Laserfiche WebLink
® E E R E T T <br />PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 10115 EVERGREEN WAY Permit #: B2103-065 <br />TENANT: GROCERY OUTLET BARGAN MARKET <br />DESCRIPTION OF WORK: NEW RETAIL GROCERY STORE IN EXTG STRIP MALL <br />PW Reviewer to select all that apply below: <br />Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connection to main plus connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration ❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total: $ <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ <br />❑ Reconnection to stub ❑ Water Service Line (behind meter), Size <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />PLWOT REQUIRED gNOT REQUIRED <br />Explanation/ Utility Permit #: Explanation/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑ 1/4" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑�B"�ackflow Prevention (Outside Building): D DCDA <br />, <br />❑ Backflow Prevention (Outside Building): ❑ DCVA �NOT REQUIRED <br />7F NOT REQUIRED Explanation/ Utility Permit #: <br />Explanation/ Utility Permit #.- <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(/fyes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity See attached for reference. <br />id -NOT REQUIRED <br />Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />❑ Backflow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />NOT REQUIRED <br />BuildinC, f Permits (Note: Permit Technicians to add all items selected below to associated <br />Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />❑ YES, ❑ See Attached for calculations / credit <br />ES, Traffic Mitigation Total: $ <br />To be added on PW To be added on <br />See Attached for calculations / credit <br />Quantity charged SF Quantity charged SF <br />NOT REQUIRED e <br />t <br />QTY is ❑ Ground only ❑ all hard surfaces QTY is ❑ Roof only ❑ all hard surfaces <br />00 .-e-tck I.Cd <br />,RIOT REQUIRED <br />QN <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />DYES -TYPE: ❑ SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />❑ See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />❑ Digital copy attached to permit record, Permit # <br />❑ Saved to Address Folder in Development Tech File <br />aYNOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES -Type <br />R!�PdOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, Permit # PW <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />PtNOT REQUIRED <br />Worksheet Completed By —._i ®%�f-. x� Date: 6 7 <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />